CASE STUDIES

Silicone gel sheeting and topical silicone gel have been used for many years as a successful treatment for a variety of scar types, both old and new. Such scar types include keloids, burns, hypertrophic scars, and scars from trauma, cosmetic procedures, C-sections, and abdominoplasty. Browse case studies below of patients using NewGel+ sheeting or NewGel+E as a scar management solution, along with before-and-after photos.

CASE STUDY – PEDIATRIC OPEN HEART SURGERY

ABSTRACT: Silicone gels have long been used to help prevent abnormal scar formation after surgery, and to promote an aesthetic scar outcome. Ease of use, patient compliance and tolerability make it a viable alternative to silicone gel sheets, with multiple published scar treatment guidelines recommending its use. This case demonstrates an excellent aesthetic outcome of a pediatric open heart surgery scar.

PROTOCOL: This case demonstrates the effectiveness and tolerability of NewGel+E when used on an infant. Treatment was initiated 5 weeks after surgery, and gel was applied twice daily for 12+ weeks.

PROCEDURE: Three month old female patient underwent open heart surgery by medical team listed above to repair both Atrial Septal Defect (ASD) and Ventricular Septal Defect (VSD). Five weeks after surgery the patient’s mother began twice daily treatment of the chest scar with NewGel+E. Treatment continued for 12+ weeks, with photos documenting progress taken frequently during treatment period.

RESULTS: Redness of the chest scar improved significantly by end of treatment period, as did the softness of the scar. Figure 3 shows a barely perceptible scar remaining four months after treatment was initiated. Mother reports no irritation at the treatment site due to the product, and the patient tolerated the twice daily application very well.

CONCLUSION: The photographs demonstrate significant improvement in the cosmetic appearance of the infant’s scar. NewGel+E would be a valuable treatment option for similar scars. The fact that silicone gels like NewGel+E do not penetrate the skin surface make them a safer option for pediatric patients.

CASE REPORT— ARM SCAR FOLLOWING ORTHOPEDIC SURGERY

PATIENT: J.K. is a ten year old healthy boy who suffered from a complex fracture of his left ulna on the 31st of August, 2016.

PROCEDURE: He underwent open reduction and internal fixation on the same date.

SCAR TREATMENT PROTOCOL: One month after the surgery, he started using a commercial ointment for the scars as prescribed by his primary physician. His parents weren’t satisfied with the results and referred to us for scar management in late November 2016. They started using NewGel+E silicone gel twice daily starting December 2016 until July 2017 as instructed.

RESULTS: A significant improvement was noted with time. At the time this case presentation was written, that is one year of the surgery, the patient showed a significant improvement with satisfactory results. Our experience with NewGel+E silicone gel for treating hypertrophic scars is impressive, mainly following surgical interventions.

FIG 1: NOV 26, 2016Photo taken three months post-surgery, The patient had used a commercial scar treatment for two months at this point.

FIG 2: MAY 7, 2017Photo shows improvement in redness and texture of scar after twice daily use of NewGel+E silicone gel for 6 months.

CASE STUDY – ACHILLES TENDON REPAIR

ABSTRACT: NewGel+ for Keloid Scar Following Achilles Tendon Repair Surgery Patient Susan Farley, Wilmette, IL HISTORY: Patient was participating in a TRX exercise class when she ruptured her Achilles tendon. Her orthopedic surgeon performed surgery to repair the ruptured tendon. Post-surgery, patient was left with a 6 inch scar which formed a keloid as it was healing. At six months post-surgery, the patient expressed unhappiness with the appearance of her scar. Her surgeon recommended the use of NewGel+ silicone gel sheeting to treat the scar.

CASE STUDY – FACIAL SKIN CANCER DEFECT

ABSTRACT: Silicone based products are commonly used to prevent and treat post-surgical skin scars. This case demonstrates the early results of a silicone ointment in a patient who underwent excision and reconstruction of a skin cancer on her cheek. After 7 weeks, the scar is minimal and can easily be concealed with a small amount of makeup. These types of results are particularly important on the face since patients are fearful and anxious about significant scaring and disfigurement.

PROTOCOL: This case demonstrates patient use and compliance of NewGel+ silicone ointment product. NewGel+ silicone ointment was started 7 days after the procedure and applied twice daily for 7 weeks.
PROCEDURE: Fig. 1 shows a 46 year female patient presented with a nonhealing cheek lesion that was diagnosed as a basal cell carcinoma after a shave biopsy. Fig. 2 shows the patient after lesion excision using a Mohs technique that resulted in a 12 x 15 mm full thickness defect. A complex repair was done and sutures were removed on day 7(Fig. 3). Scar treatment was started the next day.
RESULTS: Fig. 4 shows minimal cheek scaring 7 weeks after the procedure. The scar is flat and thin with minor redness. The patient was pleased with the results and found the NewGel+ silicone ointment easy to use.
DISCUSSION: Excision of benign and malignant skin lesions are a common problem that causes patient apprehension due to potential for significant scars on a prominent and socially important body region. Although most scars fade after a few months, a protocol to minimize scars is useful, particularly in patient who are more sensitive about their appearance. All patients should be informed that any skin lesion excision will result in a visible scar and the possibility of future scar revisions. They should also be educated on the importance of techniques to minimize scar visibility such as scar massage, sun protection and the use of silicone based products on a routine basis. Patient compliance can be improved by providing patients with written instructions and educational material describing the use of silicone based products, a product sample with more product availability at future visits, and scar management discussions at each follow up visit.
CONCLUSION: This case shows the significant improvement in facial scaring after skin lesion excision when NewGel+ silicone ointment is incorporated as part of a scar management protocol. Patients who are preparing for excision of facial lesions should be provided a standard scar treatment protocol that includes a silicone based ointment.

CASE STUDY – FACIAL TRAUMA

Shown below are photos of a 24 year old college student that sustained this laceration during an assault with a knife. The wound was through-and-through the upper lip and cheek. It was sutured and repaired primarily in the emergency department.

This case demonstrates the effective results after treatment of an acute facial laceration with NewGel+.

OCTOBER 27, 2007 (BEFORE USING NEWGEL+)Approximately 2 weeks after the lip repair, he was treated with NewGel+ which he used 12 hours per day seven days per week.

FEBRUARY 15TH, 2008 (AFTER 12 WEEKS USING NEWGEL+)The pictures taken at 12 weeks post injury show a dramatic result with no perceptible scar across the lip or vermillion border. Only a small portion of the scar in the upper third of his face is minimally visible.

CASE REPORT: SILICONE GEL SHEETING FOR TREATMENT OF COMPLEX KELOID

January 21st, 2009 (Before using NewGel+)The keloid began to form again after first keloid scar was surgically removed.

March 5th, 2009 (After only 6 weeks of using NewGel+)keloid scar was surgically removed. After six weeks of treating the keloid with NewGel+.

ABSTRACT: Silicone gel sheeting has been used for many years as a treatment for hypertrophic and keloid scars. This case report presents a patient who sustained a complex keloid scar in the right side of the face and had significant improvement by preventing the keloid from forming again after using the NewGel+ silicone gel sheeting.

HISTORY: The patient is a 56 year old woman who had a complex old keloid that formed several years ago from a previous injury. On November 20, 2008, the keloid was surgically removed. On January, 21, 2009, the patient complained of keloid formation again, as well as discomfort and a sensation of tightness around the surgical area. The patient started treatment with NewGel+ topical silicone gel sheeting placed over the scar.

RESULTS: The patient used NewGel+ silicone gel sheeting over the surgical scar area that started to form another keloid scar. As shown in Fig-3 the patient had significant improvement in removing and preventing the keloid from forming as well as significant fading of the surgical scar being treated with only NewGel+ silicone gel sheeting.

CONCLUSION: This case report describes a patient who had significant overall improvement in the hypertrophic scarring of her complex keloid scarring of the right side of the face.

ABSTRACT: Silicone gel sheeting has been used for some time to manage scars, including scars resulting from burns. This study was done to determine if silicone gel sheeting would affect the healing of a scar after deep first and deep first and deep second degree burns involving the left hand forearm. Early results demonstrate improvement in healing of the second burn with no evidence of any contracture or hypertrophic scarring, good color matching of the skin and improved patient satisfaction.

PROTOCOL: This study was done as a pilot study to qualitatively determine if the application of silicone gel sheeting using the NewGel+ product can affect scar appearance after standard burn treatment and burn management. The 20 year female patient presented with a campfire injury and burns to her lefthand with no other significant medical problems and no contraindications to the use of silicone gel with no previous sensitivity documented.

PROCEDURE: The first photo (Fig 1), taken after the initial standard burn treatment and burn management, depicts a lefthand and forearm with deep first and deep second degree burns involving the dorsum of the hand and forearm, the first webspace and the plamer surface of the hand, Also noticeable are several spots of third degree burns on the forearm. At this point, silicone gel sheeting was provided(NewGel+) and applied to the burn site. The patient was instructed to wear the silicone gel sheeting daily for a minimum of 8 hours per day.

RESULTS: After treatment of the hand and forearm for ten days with NewGel+, the patient was re-assessed with photos (see, Fig.2 and clinical assessment). There was significant acceleration of healing. The third photo (See, Fig.3) was taken two months post New Gel+ application showing complete healing of the second degree burn with no evidence of any contracture or hypertrophic scaring over the dorsal surface of the hand and the first webspace with good color matching of the skin. Also noted was resolution of the third degree burn spots on the forearm.

DISCUSSION: Normal burns scars take an average of six to nine months to mature and blend with the adjacent skin. Also, deep second degree burns usually heal with scar contracture and hypertrophy, especially when it involves the dorsal surface of the hand, forearm and the first webspace. Silicone gel sheeting has had a beneficial effect on the cosmetic appearance of a post-burn scar in a patient with deep first degree and deep second degree burns involving the dorsum of the hand, forearm, first webspace and the palmer surface of the hand. This patient had no risk factors for abnormal healing and was otherwise healthy. The results seen at ten days post-treatment are somewhat surprising since one would not expect a dramatic change this early in the healing phase. Results seen after two months treatment show no evidence of scar contracture or hypertrophy, indicating a clinically significant effect from the application of silicone gel sheeting. Al thought the mechanism of action of silicone gel sheeting has yes to be determined, this pilot study clearly has demonstrated an improvement in scar appearance and patient satisfaction. This case study is encouraging and suggest that silicone gel sheeting can improve outcomes and patient satisfaction.

CONCLUSION: This case study has demonstrated significant improvement in the early cosmetic outcome of scars resulting from vertical reduction mammoplasty. Patient satisfaction has also been improved. Consideration may be given to the use of silicone gel sheeting in the early post-operative period.

UNTREATED BREASTAfter 7 weeks with no treatment. Study discontinued so this breast could be treated.

ABSTRACT: Silicone gel sheeting has been used for some time to manage scars, including scars resulting from burns. This study was done to determine if silicone gel sheeting would affect the healing of a scar after deep first and deep first and deep second degree burns involving the left hand forearm. Early results demonstrate improvement in healing of the second burn with no evidence of any contracture or hypertrophic scarring, good color matching of the skin and improved patient satisfaction.

PROTOCOL: This study was done as a pilot study to qualitatively determine if the application of silicone gel sheeting using the NewGel+ product can affect scar appearance after standard burn treatment and burn management. The 20 year female patient presented with a campfire injury and burns to her lefthand with no other significant medical problems and no contraindications to the use of silicone gel with no previous sensitivity documented.

PROCEDURE: The first photo (Fig 1), taken after the initial standard burn treatment and burn management, depicts a lefthand and forearm with deep first and deep second degree burns involving the dorsum of the hand and forearm, the first webspace and the plamer surface of the hand, Also noticeable are several spots of third degree burns on the forearm. At this point, silicone gel sheeting was provided(NewGel+) and applied to the burn site. The patient was instructed to wear the silicone gel sheeting daily for a minimum of 8 hours per day.

RESULTS: After treatment of the left side for seven weeks with NewGel+, the patient was re-assessed with photos (see Fig.3) and clinical assessment. There was significant less wrinkling of the scar and essentially no redness. The scar was clearly flat and softer. The patient could clearly see a difference and was much more satisfied with the results on the treated side. Due to the dramatic changes demonstrated, the study was discontinued and silicone sheeting applied to the right side (see Fig. 4) as well as the left, for on-going scar management.

DISCUSSION: Silicone gel sheeting has had a beneficial effect on the cosmetic appearance of a post-operative scar in a patient undergoing a vertical reduction mammoplasty. Although the mechanism of action has yet to be determined, this pilot study clearly has demonstrated an improvement in scar appearance and patient satisfaction. This patient had no risk factors for abnormal healing, was a nonsmoker and otherwise healthy. Also, she had a modest sized reduction mammoplasty and would be expected to heal without complications. The results seen at 10 weeks post-operatively are somewhat surprising since one would not expect a dramatic change this early in the healing phase. It would be anticipated that scar remodeling would have to take place over many months, with scar maturation to occur, prior to seeing a clinically significant effect from the application of silicone gel sheeting. However, this study has demonstrated an early effect. Certainly, before recommending the wide-spread and routine use of silicone gel sheeting in reduction mammoplasty, further study is required to investigate the affects on a variety of skin types, reduction size, reduction techniques, and concomitant risk factors. However, this case study is encouraging and suggests that silicone gel sheeting can improve cosmetic outcome and patient satisfaction.

CONCLUSION: This case study has demonstrated significant improvement in the early cosmetic outcome of scars resulting from vertical reduction mammoplasty. Patient satisfaction has also been improved. Consideration may be given to the use of silicone gel sheeting in the early post-operative period.

Fig2. Same patient 12 days after body contouring surgery, NewGel+gel sheets started

Fig3. Three months after using NewGel+ gel sheets

ABSTRACT: Silicone gel sheeting is an accepted modality for prevention and treatment of post-surgical cutaneous scars. This case demonstrates the early and intermediate results of silicone gel sheeting use in a patient who underwent body contouring for post-bariatric massive weight loss. At 3 months, the breast and abdominal incisions are minimal and better than typically seen after similar procedures where silicone gel sheeting is not used.

PROTOCOL: This case was chosen to illustrate the utility and patient acceptance of silicone gel sheeting using the NewGel+ Silicone gel sheet product. The 55 year female patient presented with significant skin excess in the trunk and breasts after a 90 pound weight loss following bariatric surgery. She was otherwise healthy and did not have any contraindications to use of silicone gel topical treatment. She was instructed to use gel sheets starting 1 to 2 weeks after surgery for 12 to 18 hours per day for 3 months.

PROCEDURE: Fig.1 shows the skin excess before the patient underwent a circumferential abdominaoplasty and bilateral mastopexy with autologous tissue augmentation. Fig.2 shows the patient 12 days after surgery with typical swelling and bruising. This is an acceptable time to start scar management with silicone gel sheeting.

RESULTS: Fig.3 shows dramatic improvement in breast and abdominal scar appearance 3 months after surgery. The scars are thin and flat with areas of fading redness. The patient was very pleased with the results and very accepting of following the NewGel+ silicone gel sheeting treatment protocol.

DISCUSSION: Abdominal and breast scars may be very prominent following body contouring surgery and improvement may occur for 1 to 2 years. Patients undergoing these aesthetic procedures typically expect a quick improvement and minimal or no surgical scars. While all patients should be cautioned that major body contouring surgery will result in visible scars(with possible future scar revisions), they should also be counseled on the importance of modalities to minimize scar visibility such as scar massage, sun protection and the use of silicone based on a regular basis. patient compliance with use of silicone based scar products can be improved by providing patients with written instructions and educational material, a product sample with more product availability at future visits, and scar management discussion at each follow up visit .

CONCLUSION: This case study has demonstrated significant improvement in the cosmetic outcome and the prevention of contracture often seen in scars resulting form deep first and deep second degree burns, Patient satisfaction has also been improved. Consideration may be given to the use of silicone gel sheeting in the treatment of scars resulting from such burns.

SILICON GEL SHEETING FOR TREATMENT OF HYPERTROPHIC SCARRING OF THE ARM FOR COMPLEX OPEN WORD OF THE ARM-A CASE STUDY

ABSTRACT: Silicon gel sheeting has been used for many years now as a treatment for hypertrophic and keloid scars.This case report presents a patients who sustained a complex open wound of the upper arm and developed hypertrophic scarring and who had significant improvement with topical silicone gel sheeting.

HISTORY: This patient is a 44year old women who was injured when she was attacked by her horse and sustained a complex open wound avulsion injury of her anterior left upper arm from a horse bite(Fig.1).The patient had a complete loss of skin and soft tissue down ti the biceps fascia with a defect measuring 10 x 15cm. the patent presented to the emergency room.The avulsed tissue was surgically replanted The patent was taken to the operating room that day, where the avulsed tissue was surgically replanted.Unfortunately this tissue did not survive,and the patent was left with a complex wound measuring 10x 15cm.The tissue was surgically debrided, and this complex open wound was allowed to granulate.The patient was returned to the operating room approximately 1month later for her second procedure.The patient had a split thickness skin graft reconstruction of the complex open wound.The patient’s split thickness skin graft healed with a 100% take, but the patient developed hypertrophic scarring, particularly around the edges of the graft(Fig.2).The patient complained of discomfort and a sensation of tightness around this area of grafting.This hypertrophic scarring was treated with placement of topical silicon gel sheeting.

RESULTS: The patient used NewGel+ silicon gel sheeting over the area of scarring and split thickness skin topically once the area of split thickness skin grafting had completely healed, beginning about four months after her original injury and about three months after her split thickness skin graft.Patient had significant improvement in her scarring with improvement in thickness, redness and tightness of the scar with her topical scar management(Fig.3).Fig.4 shows even more significant improvement after 4 months of using NewGel+.

CONCLUSION: This case report describe a patient who had significant overall improvement in her hypertrophic scarring of her complex open would of the upper arm with the use of topical silicone gel sheeting.